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Evaluating optimal bilateral biliary stenting in endoscopic reintervention after initial plastic stent dysfunction for unresectable malignant hilar biliary obstruction: Retrospective cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Evaluating optimal bilateral biliary stenting in endoscopic reintervention after initial plastic stent dysfunction for unresectable malignant hilar biliary obstruction: Retrospective cross-sectional study.
المؤلفون: Okuno M; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan., Iwata K; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan., Iwashita T; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Mukai T; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan.; Department of Gastroenterological Endoscopy, Kanazawa Medical University, Ishikawa, Japan., Shimojo K; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan., Ohashi Y; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan., Iwasa Y; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan., Senju A; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Iwata S; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Tezuka R; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Ichikawa H; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Mita N; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Uemura S; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan., Yoshida K; Department of Gastroenterology, Gifu Prefecture General Medical Center, Gifu, Japan., Maruta A; Department of Gastroenterology, Gifu Prefecture General Medical Center, Gifu, Japan., Tomita E; Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan., Yasuda I; Third Department of Internal Medicine, University of Toyama, Toyama, Japan., Shimizu M; First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
المصدر: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society [Dig Endosc] 2024 Mar 14. Date of Electronic Publication: 2024 Mar 14.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons Australia, Ltd Country of Publication: Australia NLM ID: 9101419 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1443-1661 (Electronic) Linking ISSN: 09155635 NLM ISO Abbreviation: Dig Endosc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2019- : Richmond, Vic., Australia : John Wiley & Sons Australia, Ltd.
Original Publication: Tokyo, Japan : The Society, c1989-
مستخلص: Objectives: The placement of plastic stents (PS), including intraductal PS (IS), is useful in patients with unresectable malignant hilar biliary obstruction (UMHBO) because of patency and ease of endoscopic reintervention (ERI). However, the optimal stent replacement method for PS remains unclear.
Methods: This retrospective study included 322 patients with UMHBO. Among them, 146 received PS placement as initial drainage (across-the-papilla PS [aPS], 54; IS, 92), whereas 75 required ERI. Eight bilateral aPS, 21 bilateral IS, and 17 bilateral self-expandable metallic stent (SEMS) placements met the inclusion criteria. Rates of technical and clinical success, adverse events, recurrent biliary obstruction (RBO), time to RBO (TRBO), overall survival, and secondary ERI were compared.
Results: There were no significant intergroup differences in rates of technical or clinical success, adverse events, RBO occurrence, or overall survival. The median TRBO was significantly shorter in the aPS group (47 days) than IS (91 days; P = 0.0196) and SEMS (143 days; P < 0.01) groups. Median TRBO did not differ significantly between the IS and SEMS groups (P = 0.44). On Cox multivariate analysis, the aPS group had the shortest stent patency (hazard ratio 2.67 [95% confidence interval 1.05-6.76], P = 0.038). For secondary ERI, the median endoscopic procedure time was significantly shorter in the IS (22 min) vs. SEMS (40 min) group (P = 0.034).
Conclusions: Bilateral IS and SEMS placement featured prolonged patency after first ERI. Because bilateral IS placement is faster than SEMS placement and IS can be removed during secondary ERI, it may be a good option for first ERI.
(© 2024 Japan Gastroenterological Endoscopy Society.)
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معلومات مُعتمدة: JP23K14646 JSPS KAKENHI
فهرسة مساهمة: Keywords: intraductal stent placement; malignant hilar biliary obstruction; plastic stent; reintervention; self-expandable metallic stent
تواريخ الأحداث: Date Created: 20240315 Latest Revision: 20240315
رمز التحديث: 20240315
DOI: 10.1111/den.14776
PMID: 38486465
قاعدة البيانات: MEDLINE
الوصف
تدمد:1443-1661
DOI:10.1111/den.14776